Name of Vendor (Promiser)

Company Name

Email

Phone Number

License Number

MUST LIST ALL FOOD ITEMS as per Item #14 above

MUST provide a $2M Certificate of Insurance MUST provide a $2M Certificate of Insurance Yes

Must complete Special Vendor Application and submit with payment to Fuerza Latina Must complete Special Vendor Application and submit with payment to Fuerza Latina Yes

I agree to all terms and conditions and have fully read the document above I agree to all terms and conditions and have fully read the document above Yes

Food Vendor (Promiser) Signature

Date

By electronically signing or submitting the agreement online, the Food Vendor (Promisee) agrees to be legally bound by its terms, with electronic signatures having the same effect as handwritten ones. By electronically signing or submitting the agreement online, the Food Vendor (Promisee) agrees to be legally bound by its terms, with electronic signatures having the same effect as handwritten ones.